Resident Awareness of Documentation Requirements and Reimbursement: A Multi-Institutional Survey
Resident Awareness of Documentation Requirements and Reimbursement: A Multi-Institutional Survey
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DOI：
10.1016/j.athoracsur.2013.09.100
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发表时间：
2014-03-01
影响因子：
4.6
通讯作者：
Lau, Christine L.
中科院分区：
文献类型：
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作者：
Yount, Kenan W.;Reames, Bradley N.;Lau, Christine L.
背景当前的经济环境需要努力防止学术心胸外科项目中临床收入的可避免损失。文件不足经常导致延迟、拒绝或减少报销。随着最近增加的综合居住计划，文件和遵守越来越依赖于初级居民，但是，他们的理解报销和文件的指导方针是目前未知的。对6个普通和专科手术项目进行了一项电子分发的多机构调查，包括对不同级别患者的医疗保险报销的开放式数字估计。封闭式问题被用来评估居民的知识的文件要求，伴随着自我估计遵守这些要求。37%（n = 106）的居民完成了调查。大多数居民（77%）认为他们在文件中发挥主要作用;然而，知识和遵守更高级别的文件实践范围分别为19%至78%和41%至76%。平均而言，居民高估了医疗保险报销低水平的遭遇高达77%，低估了高水平的遭遇高达38%。在许多情况下，居民估计的标准差接近实际报销价值。居民对文件要求的了解有限。自我报告的遵守情况，即使知道指导方针，也很低。对财务偿还的估计差异很大。居民高估了低水平遭遇的报销，低估了高水平的报销。确保对所提供服务的适当补偿将需要正式的心胸外科住院医师教育和持续的质量控制。(C)2014年由胸外科医师协会
Background. The current economic environment necessitates efforts to prevent avoidable losses in clinical revenue in academic cardiothoracic surgery programs. Inadequate documentation frequently results in delayed, denied, or reduced reimbursement. With the recent increase in integrated residency programs, documentation and compliance are becoming increasingly dependent on junior residents; however, their understanding of reimbursement and documentation guidelines is currently unknown.Methods. An electronically distributed, multi-institutional survey of 6 general and subspecialty surgery programs was conducted consisting of open-ended numeric estimation of Medicare reimbursement for various levels of patient encounters. Closed-ended questions were used to assess resident knowledge of documentation requirements, accompanied by self-estimated compliance with those requirements.Results. Thirty-seven percent (n = 106) of residents completed the survey. Most residents (77%) believe they play the primary role in documentation; however, knowledge of and compliance with higher level documentation practices range from 19% to 78% and 41% to 76%, respectively. On average, residents overestimate Medicare reimbursement of lower level encounters by as much as 77% and underestimate higher level encounters by as much as 38%. In many cases, the standard deviation of residents' estimates approaches the actual reimbursement value.Conclusions. Residents have a limited knowledge of documentation requirements. Self-reported compliance, even when guidelines are known, is low. Estimation of financial reimbursement is extremely variable. Residents overestimate reimbursement of lower level encounters and underappreciate reimbursement at higher levels. Ensuring appropriate reimbursement for services rendered will require formal cardiothoracic resident education and ongoing quality control. (C) 2014 by The Society of Thoracic Surgeons